Portrait of Injustice: Abortion Coverage under the Medicaid Program
State Coverage of Medically Necessary Abortions
When abortion was first legalized in 1973, federal funds were available to low-income women seeking medically necessary abortions. But four years later, Representative Henry Hyde (Rep-IL) sponsored a bill that eliminated federal funding for abortion except when necessary to save the woman's life. The Hyde Amendment has since been renewed by Congress every year with a range of restrictions.
Since 1993, the amendment has permitted Medicaid funding for cases of rape and incest, and to save a woman’s life when it is endangered by a physical disorder, injury or illness. Some states have voluntarily chosen to extend the coverage mandated by the Hyde Amendment to include all medically necessary abortions. Other states provide more coverage than mandated by the Hyde Amendment, but do not cover all abortions that are medically necessary to preserve the health of the woman. Two states, Mississippi and South Dakota, continue to limit funding only to life threatening pregnancies, in violation of the Hyde Amendment.
The Center for Reproductive Rights and other groups have brought lawsuits on state constitutional grounds in some states that refuse to cover medically necessary abortions. These lawsuits argue that state constitutions provide greater protection for women’s privacy and reproductive choices than the federal Constitution. As a result, some states now provide coverage under court order.
States ordered by court to provide coverage for all medically necessary abortions (13)
States voluntarily providing coverage for all medically necessary abortions (3)
States ordered by court to provide coverage for some, but not all, medically necessary abortions (1)
States voluntarily providing coverage for some, but not all, medically necessary abortions (4)
States where litigation has been unsuccessful in securing coverage (7)